Exploring the comorbidities associated with osteoarthritis

Osteoarthritis is the most common arthritis worldwide, and has an increasing global burden of disability and healthcare utilization. It is also associated with various comorbidities, and this link has gained attention in recent years.

In the 2023 update of their recommendations for osteoarthritis management, EULAR – The European Alliance of Associations for Rheumatology – recognize osteoarthritis as a severe disease, and one with important implications for both the individual and society. However, most people with osteoarthritis do not receive optimal management. and this represents an important unmet need – especially when considering additional systemic comorbidities. To explore this further, ComOA has combined case-control and cohort studies for over 3 million people in primary care in the UK, Netherlands, Sweden, and Spain. The analyses – shared at the 2024 EULAR congress in Vienna – examines associations between osteoarthritis and 61 different comorbidities identified before and after the first osteoarthritis diagnosis. The researchers then tested the similarity of their findings across the four countries – where congruency was determined to be present if the results of all centers were significant and favored in one direction.

Across the four databases there were 845,373 osteoarthritis cases and 2,556,243 controls. Pooled prevalence data showed several conditions that were more common in people with osteoarthritis than in matched controls. The conditions with leading prevalence were chronic back pain, hypertension, allergy, cataract, vertigo, depression, and diabetes. Of 33 comorbidities studied, 10 such as fibromyalgia, polymyalgia, and chronic back pain showed congruent evidence of association with osteoarthritis during the diagnosis across the four countries. The three major comorbidities developed after the diagnosis of osteoarthritis were fibromyalgia, rheumatoid arthritis, and polymyalgia. No congruent evidence of association with either before or after the diagnosis of osteoarthritis was found for 14 chronic conditions, including heart failure, diabetes, dementia, and chronic obstructive pulmonary disease.

These are important findings to consider for planning management of people with osteoarthritis, and suggest further research is warranted to establish the causal association between osteoarthritis and its comorbidities.